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HomeMy WebLinkAboutPERMIT APP - 3 SAN LUIS OBISPOALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x PERMIT APPLICATION FOR: Building PROPOSED IMPROVEMENT LOCATION: Address: 3 SAN LUIS OBISPO Legal Description: EAST 1/2 OF SECTION 1 - TOYVNSHIP 34S - RANGE 391E Property Tax ID #: 1361A 11-0001--000-5 Site Plan Name: COUNTRY CLUB VILLAGE Project Name: Setbacks Front 33' Back: Right Side: 18' Left Side: 14' Lot No. Block No. SINGLE FAMILY RESIDENCE (replacement home) - 2 BEDROOMS - 2 BATHS - GARAGE NO SLAB WILL BE BUILT OFF REAR OF HOME L±JHVAC U Gas Tank ©Electric OPlumbing Total Sq. Ft of Construction: 2,108 Cost of Construction: $ 58,000 uncer tnis perm¢—cnecK an appry: ❑Gas Piping _ Shutters Q Windows/Doors Sprinklers 11 Generator Roof S Ft. of First Floor: 2,108 Utilities:nSewerOSeptic Building Height:_ OWNER/LESSEE: CONTRACTOR: Name WYNNE BUILDING DEPARTMENT Name: MATTHEW LYLE WYNNE Address: 8000 SOUTH US HWY. 1 - SUITE 402 Company: WYNNE DEVELOPMENT CORPORATION City: PORT ST. LUCIE State: FL Zip Code: 34952 Fax: (772) 878-7656 Phone No. (772) 878-5513 Address: 8000 SOUTH US HWY. 1 - SUITE 402 City: PORT ST. LUCIE State: FL Zip Code: 34952 Fax: (772) 878-7656 Phone No. (772) 878-5513 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner fisted above) E-Mail: State or County License: 08898 If value of construction is 52500 or more, a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I DESIGNER/ENGINEER: _ Not Applicable Name: BRADEN&BRADEN Address: 417C000NUTAVE. City: STUART State: FL Zip: 3a> Phone: (772)�742se FEE SIMPLE TITLEHOLDER. _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before _ Signature of Owner/ Lessee/Agent STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S LC tc COUNTY OF 1 - /—c c4c.7 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 2,Cdayof "lA-KCW , 20aL by this---<dayof k77i0x" .20_2L__by 4J`,47`F1WCZJ LYC-e 1",o477 eZ-_) CYt-F 1NVI'VIye (Name of person acknowledging ) (Name of person acknowledging ) t.1L9-�OTr`� a--V� ilJaalG_ v- Low 44 a-y" 6a a -A.. - (Signature of Not ublic- State of Florida ) (Signature of Nota blic- State of Florida ) Personally Known I/ OR Produced Identification Type of Identification Produced Commission No. My COMMISSION # HH 045443 Bonded Thmu Personally Known r/ OR Produced Identification Type of Identification Produced Commission No. s^."'w' DOP,OTHO"PASKIN W COMMISSION # HH 045443 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS f I PERMIT # I ISSUE DATE PLANNING & DEVELOPMENT SERVICES a Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT S & W ELECTRIC, INC. have agreed to be (Company Name/Individual Name) the_ ELECTRICIAN Sub -contractor foF-W-YNNEQEVELOPMENr_CORP.- (Type of Trade) (Primary Contractor) For the project located at (Project Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub -contractor notice. CONTRACTOR SIGNATURE (Qualifier) SUB -CONTRACTOR SIGNATURE (Qualifier) MATTHEW LYLE WYNNE PRINT NAME COUNTY CERTIFICATION NUMBER State of Florida, County of ST. LUCIE The foregoing instrument was signed before me this�Z day of rr�V\ 203( by MATTHEW LYLE WYNNE who is personally known % or has produced a as identification. Signature of Notary Ic s DOROTHY ANNBASKIN Print Name of Notary Public DOROTHYANN BASKIN *: +e MY COMMISSION# M o4SW EXPIRES:OcbW22024 Bonded llau Notary pubilci wdtora LAWRENCE STUBBS PRINT NAME r oaiFA COUNTY CERTIFICATION NUMBER —State of Florida, County of ST. LU.CIE__ _, The foregoing instrument was signed before me thist�� of M ' Ci' 20�Dl by LAWRENCE STUBBS who is Personally known V or has produced a as identification. STAMP �������� e of Notary Pubficof Notary Public Ilium ti , & Print Name of Notary Public Z. LAURARCUBSEDGE 'j),A��`' Commission # HH 013089 Expires October 21, 2024 :41�n°.• Bonded Thu Troy Fain lnsurdnm 80048+7019 STAMP PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT AQUA DIMENSIONS have agreed to be (Company Namedndividuai Name) the PLUMBER Sub -contractor for WYNNE DEVELOPMENT-CORP. (Type of Trade) (Ptimazy Co\\ntractor) For the project located at (Project Street Address or Property Tax ID #) It is understood that, if there. is anychange of status regarding our participation with the above mentioned project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub -contractor notice. CONTRACTOR SIGNATURE (Qualifier) MATTHEW LYLE WYNNE PRINT NAME , COUNTY CERTIFICATION NUMBER State of Florida, County of ST'LUCIE Theforewiug Instrument was signed before me iId day of wao is personally known V or has produced a as �identification. MUM- fication. STAMP �'�l�iJ71V�,� Signature of Notary u tie Signature-ofNo I ` STAMP tarY Pabhc ' ("')) RHONDA LAFFERTY Print Name of Notary Public RHONDA LAFFERiy =?: _ - MY COMMISSION # GG058720 "rursC�.$ EXPIRES January 08, 2021 SUB-C SIGNATURE (Quabfier) ROBERTLUDLUM PRINT NAME 18628 DOROTHYANN BASKIN Print Name of Notary Public 'v'"•'• D0.40TtiYANNBASKIN I WCOMMISSION#HIi045443 --so EXPIRES:Gcfobet2,2024 Thru Notary PM lkWenvriters COUNTYCERTIFICATION NUMBER State of Florida, County of ST. LUCIE The foregoing instrument wassigned before = this �� of who is personally kn~aV—pr has produced a PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division lau)lDIhtG PERMIT SUB -CONTRACTOR AGREEMENT Comfort Control of St. Lucie County, Itc. haveagreedto'be (Company Nameffndividuai Name) the HVAC Sub-contractorfor. Winne Development Corp. (Type of Trade) (Primar Contractor) For the project located at_ (Project Street Addressor property It is understood.that, if there is any change of status regarding our participation with the above mentioned. project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the . filing of a Change of Sub -contractor notice. CONTRACTOR S[(WATURE (Qualifier). Matthew Lyle Wynne PRAT NAM1 ;ff-or—DW COUNTY CERTIFICATION NUMBER State ornorida, County 1C\ The foregoing insaumeut was signed hefor¢me � day of \,}�A 847&J .20� who is personally known Zor has prodaeed a as identff eatim OL4)4 . Signature of Notary public ` JJ_r7Ro—lwyV"'V 44-Velr) PribtName of Notary Pnbhe DOROTHYANNBASKIN MYCOMMISSION#HH045443 ' v EXPIRES:Oclobat2.2024 m�f�OP 0oadedrhfu Notarypehibundenn@oa Revised ttnenal� 8288 COUNTY CBRTMCATION NUMBER State of Florida, County The foreZoizZ instrnmemi wag sipped before me this -�L day of who is personally known V or hag produced so ' s9 ident5cafion. /� �/� STAMP agIt �_ (�l�n �.r91SL ��" STAMP Signature of Notary Pv'ft Vo o` K N Ayw �945.'Cia Print Narntof NotaryPnblle EE-ii�;Rn DOROTHYANNBASKW MYCOMMISSION#HH045443 o p�..(E...XPIRE,SS. O�ctdbet2,,�2.0_24,-_ Pi un,uW Thu Notary Pobft IJr4 MftM L66-d Z00©IZ©40d bLO-1 999L8L8ZLL chop suip[in8 euuAM -woad 9L:ZL 9L,-6©-ZL PLANNING & DEVEL�SERVICES Building.a4c.iI Compliance Division Bi UMONG PERMIT SIIB-CON1`RACLBR:AisREEN1Ela1T the Roofing s tb-connactcrfor Wynne Development Corp. (Type ofTrade) (Primary Contractor) For-- the It is wnderstood that, if there is any change of status regarding our participation with the above, mentioned project; theBuilding and Code Regulation Division of St. Lucie County will be advised .pursuantto l ie. fling ofa Changeof Sub -contractor notice. CON TRALTO&SIG TU1, M(Qualifier)' Ka -I thew Lyle Wynne pRhwNAw 1a.R &%R. COUNTY CERTIFICj1TT01N NZ�YIIiER smte ormrida, county of4Sx The foregoing;insu'muentwassig`ued b�e�x(o�cxme`=dayof who is personalty knows N or has produced a asideotifecafion:. WWt 60.1/C ... STAMP. Suguatare oFN�ohry e eJ DOROTHYANN BASKIN MY COMMISSION # HH 045443 EXPIRES: October t 2024 Revised-lUI612016. - -.SMC4ONTNA CTM S1GNAi' -(Qualifier) Brian Maloney :PRLNT N42 E C(:(: l CO(r'NTY CERTIFIGATION.N'UNiBER State of Florida, County o6—�VC.�`� 'The foregoing instrument "S signed before me this, G`�&YM: Vic: t�r� 2i�-Sbx ^7:�c1 can who is personally imown o/r hasprodueedA as�iid'entiifieatioa:, 1 //�� //�J WY✓" &1e` 06i— STAMP SigastureofNota"Irs lic. OOROTHYA7NIBASKIN MYCOMMISSION# HH 045443 EXPIRES:O*ber2, 2024 0 #1 ST.I,U COUNTY BUILDWO & ZONING 230G VIRGligU AVENUE FORT PIERCE; FL 34582-5652 772462-1553 I, the undersigned, am the owner of the following described property: b s� (Tax ehi p 44c .Range 39E, N&W of Turnpike FeedE for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number , I acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. I further acknowledge that in granting this permit for the development of this property; St. Lucie County is neither obliged nor liable to provide'for, or maintain in any form, adequate drainage off my property which will not adversely affect the immediate community. Property Owner Name Property Owner Signature Date STATE OF FLORIDA, COUNTY OF R; t- - T. i i c i -tom ACKNOWLSOO,�EO _SEFORE ME THIS _(� DAY OF / � � ,�/1 A✓«I'l , 20a� 8Y@I14s !�\eV- WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATLON. SIGNATURE OF NOTARY NOTARY PUBLIC TITLE 2oe0-j-)4Y 11WIv BAS<i^? TYPE OR PRINT NAME OF NOTARY U ylio, sC�; ,N BASK!N :'�: �1 '.,'- MY CCMMISSICNRHN 045443 °a7ior EXPLRES: Odoher 2, 2024 �I "<8P.',t��" Bonded Thru No�sry Public Unde,writers